HIV: from a devastating epidemic to a manageable chronic disease
In the decade since the United Nations declared HIV an unprecedented human catastrophe, the AIDS response has underscored the ethical imperative of fair access to medicine. WHO’s standard-setting work helped make prevention and treatment more accessible, safe, effective and efficient, and encouraged integrating HIV services into existing health systems. WHO has prequalified more than 250 products for HIV-related conditions. New targets aim to prevent 1.6 million new infections and 600 000 deaths per year, ending AIDS as a public health threat by 2030.
HIV, with its long incubation period, its multiple modes of often intimate transmission, and its defiance of monumental efforts to develop a vaccine and a definitive cure, is one of the most complex, the most challenging and arguably the most devastating of all infectious diseases that humanity has ever had to face.
In 2015, the global HIV epidemic claimed fewer lives than at any point in almost two decades, and fewer people became newly infected with HIV than in any year since 1991. The fact that the MDG target of halting and reversing the spread of HIV was met nine months ahead of schedule is a stunning achievement.
"The HIV response changed the face of public health in profound ways, opening new options for dealing with multiple other health problems."
Dr Chan, WHO Director-General
The HIV response changed the face of public health in profound ways, opening new options for dealing with multiple other health problems. Treatments can be found. Prices can plummet. Funds can be secured. High-impact services can be delivered in resource-constrained settings. Attitudes can change. Communities can be mobilized to take action. With sufficient will, commitment and resources, a bleak and depressing situation can be turned into one that offers hope.
Above all, the AIDS response underscored the ethical imperative – the life-and-death significance – of fair access to the best quality-assured medicines and diagnostics on offer, to all in need.
How this happened, including WHO’s specific role, deserves analysis. Recent achievements look all the more remarkable when viewed against the situation a decade ago. A look at these achievements also yields one of the best examples of how WHO’s standard-setting work and direct support to countries translates into lives saved and suffering averted.